经皮椎间孔镜治疗腰椎管狭窄症伴骨质疏松的有效性与安全性分析.docVIP

经皮椎间孔镜治疗腰椎管狭窄症伴骨质疏松的有效性和安全性分析 　　[摘要] 目的 探讨经皮椎间孔镜治疗腰椎管狭窄症伴骨质疏松的有效性和安全性分析。 方法 选取宝鸡市中医医院2011年2月～2014年2月收治的腰椎管狭窄症伴骨质疏松患者160例，按随机数字表法分为两组，每组80例，对照组采用常规治疗方案，观察组采用经皮椎间孔镜治疗方案，观察两组患者的多种指征（手术时间、手术出血量、卧床恢复时间），并于手术前和手术3个月后对其视觉模拟评分（VAS）和Oswestry功能障碍指数问卷表（ODI）及不良反应进行评估。 结果 观察组患者的手术时间、患者手术出血量、卧床恢复时间、VAS和ODI评分明显小于对照组，观察组的完全缓解数、部分缓解数、疾病稳定、疾病进展整体高于对照组，观察组的并发症发生率明显低于对照组，差异均有统计学意义（P 0.05），对两组患者的骨密度情况进行分析，结果显示对照组手术后的L2-4（0.95±0.06）、股骨颈（0.95±0.21）、Ward三角（0.75±0.04）、大转子（0.55±0.06）明显高于观察组的L2-4（0.69±0.06）、股骨颈（0.65±0.16）、Ward三角（0.39±0.09）、大转子（0.49±0.06），差异有统计学意义（P 0.05），随访结果显示观察组患者在治疗6个月内均痊愈，对照组患者中有2例痊愈较慢。 结论 采用经皮椎间孔镜治疗腰椎管狭窄症伴骨质疏松的方法安全有效。 　　[关键词] 椎间孔镜；腰椎管狭窄症；骨质疏松；有效性；安全性 　　[中图分类号] R681.5 [文献标识码] A [文章编号] 1673-7210（2016）04（b）-0121-04 　　[Abstract] Objective To analyse efficacy and safety of foraminal mirror therapy in the treatment of lumbar spinal stenosis combined with osteoporosis. Methods 160 patients with lumbar spinal stenosis combined with osteoporosis in Baoji Hospital of Traditional Chinese Medicine from February 2011 to February 2014 were selected and randomly divided into control group and observation group， according to random number table method， with each group of 80 cases. Control group was treated with conventional therapy， observation group was treated with percutaneous interbody aperture lens treatment options. Multiple indications （operation time， amount of bleeding in patients， the recovery time in bed） and records during surgery and with the conduct of their pain scores before surgery and three months after surgery of the two groups were observed. Related comparison （VAS and ODI） and adverse assessment were detected. Results Operative time， blood loss in patients， the recovery time in bed， VAS and ODI scores of experimental group were significantly shorter than those of control group， the number of complete remission， partial remission number of stable disease， progressive disease of observation group was higher than those in experimental group， the complication rate